Family Health International Databases Available for Fellow Research Cleaned

Family Health International Databases Available for Fellow Research “Cleaned” databases from well-designed and executed research studies offer rich opportunities for further secondary research. Such databases may address existing questions or suggest new hypotheses to explore. FHI researchers invite Fellows to conduct collaborative, secondary analyses of existing databases, examples of which follow: Clinical Research Risk Factors for Tubal Infertility This landmark case-control study of 358 nulligravid women in Mexico City with tubal infertility and 1537 controls without tubal infertility examined risk factors. Prior use of a copper IUD was not associated with an increased risk of infertility. The study was the first to gather chlamydia serology from all cases and controls and, thus, was the first to document the confounding effect of this sexually transmitted disease. One secondary study has shown that the traditional history and physical examination are poor predictors of tubal occlusion. • Hubacher D, Lara-Ricalde R, Taylor DJ, Guerra-Infante F, Guzman-Rodriguez R. Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women. N Engl J Med 2001;345:561-7. Hubacher D, Grimes D, Lara-Ricalde R, de la Jara J, Garcia-Luna A. The limited clinical usefulness of taking a history in the evaluation of women with tubal factor infertility. Fertil Steril 2004;81:6-10. • Ibuprofen for IUD Insertion This randomized controlled trial in Chile determined whether prophylactic ibuprofen could improve IUD continuation rates. Although nonsteroidal anti-inflammatory drugs like ibuprofen are effective treatment of pain and bleeding related to IUD use, this trial found prophylactic ibuprofen of no value in reducing discontinuations for these complaints. An important secondary analysis documented little pain associated with copper IUD insertion, even among women never pregnant. • Hubacher D, Reyes V, Lillo S, Pierre-Louis B, Zepeda A, Chen PL, et al. Preventing copper intrauterine device removals due to side effects among first-time users: randomized trial to study the effect of prophylactic ibuprofen. Hum Reprod 2006;21:1467-72. Hubacher D, Reyes V, Lillo S, Zepeda A, Chen PL, Croxatto H. Pain from copper intrauterine device insertion: randomized trial of prophylactic ibuprofen. Am J Obstet Gynecol 2006;195:1272-7. • Updated 11-2007 1 Clinician IUD Knowledge This randomized controlled trial compared face-to-face education versus an IUD eligibility checklist among clinicians in Nicaragua. Neither approach had a demonstrable effect on clinician knowledge or uptake of the IUD by clientele. • Hubacher D, Vilchez R, Gmach R, Jarquin C, Medrano J, Gadea A, et al. The impact of clinician education on IUD uptake, knowledge and attitudes: results of a randomized trial. Contraception 2006;73:628-33. Is Choice of Condom Helpful? This randomized controlled trial of 414 men with urethral discharge was conducted in Jamaica to determine the impact of having a choice of four different condoms versus no choice (provision of the standard latex condom). Allowing men to choose their preferred condom did not improve condom use or lower rates of sexually transmitted diseases. • Steiner MJ, Hylton-Kong T, Figueroa JP, Hobbs MM, Behets F, Smikle M, et al. Does a choice of condoms impact sexually transmitted infection incidence? A randomized, controlled trial. Sex Transm Dis 2006;33:31-5. Communicating the Effectiveness of Contraception This randomized trial of 461 women was conducted in the US to determine which educational approach would lead to better comprehension of contraceptive failure rates. Participants did not understand well the FDA-mandated table in package labeling; simple categories of effectiveness were better understood. This report is consistent with other FHI research showing that lay persons with less than college education struggle with concepts of probabilities. One secondary analysis examined the consistency between reported reasons for contraception and ultimate choice of method. • Steiner MJ, Dalebout S, Condon S, Dominik R, Trussell J. Understanding risk: a randomized controlled trial of communicating contraceptive effectiveness. Obstet Gynecol 2003;102:709-17. Lamvu G, Steiner MJ, Condon S, Hartmann K. Consistency between most important reasons for using contraception and current method used: the influence of health care providers. Contraception 2006;73:399-403. Steiner MJ, Trussell J, Mehta N, Condon S, Subramaniam S, Bourne D. Communicating contraceptive effectiveness: A randomized controlled trial to inform a World Health Organization family planning handbook. Am J Obstet Gynecol 2006;195:85-91. • • Plastic Condom: Is Newer Better? This randomized trial of 901 couples compared the efficacy of a standard latex condom to that of a polyurethane product. Despite the theoretical advantages of plastic over latex, this trial found the newer product to perform less well in preventing pregnancy. Its use may be most appropriate for those allergic to latex. Updated 11-2007 2 • Steiner MJ, Dominik R, Rountree RW, Nanda K, Dorflinger LJ. Contraceptive effectiveness of a polyurethane condom and a latex condom: a randomized controlled trial. Obstet Gynecol 2003;101:539-47. Preventing Nausea and Vomiting with Emergency Contraception This randomized trial of 343 women tested the benefit of meclizine as a pretreatment to prevent nausea among women using emergency contraceptive pills. The study was done with an older emergency contraceptive (the Yuzpe regimen). The anti-emetic reduced nausea and vomiting but increased drowsiness, as expected. In contrast, taking emergency contraception with food did not help, contrary to popular clinical advice. • Raymond EG, Creinin MD, Barnhart KT, Lovvorn AE, Rountree RW, Trussell J. Meclizine for prevention of nausea associated with use of emergency contraceptive pills: a randomized trial. Obstet Gynecol 2000;95:271-7. Female Condom and Sexually Transmitted Infections This community intervention trial in Kenya was conducted to determine whether the introduction of the female condom would reduce the incidence of sexually transmitted infections. Among women living on coffee, tea, and flower plantations in the highlands of Kenya, the introduction of the female condom had little impact on prevention of sexually transmitted infection. Several secondary analyses have been completed and published. • Feldblum PJ, Kuyoh MA, Bwayo JJ, Omari M, Wong EL, Tweedy KG, et al. Female condom introduction and sexually transmitted infection prevalence: results of a community intervention trial in Kenya. AIDS 2001;15:1037-44. Welsh MJ, Feldblum PJ, Kuyoh MA, Mwarogo P, Kungu D. Condom use during a community intervention trial in Kenya. Int J STD AIDS 2001;12:469-74. Feldblum PJ, Kuyoh M, Omari M, Ryan KA, Bwayo JJ, Welsh M. Baseline STD prevalence in a community intervention trial of the female condom in Kenya. Sex Transm Infect 2000;76:454-6. Mohamed OA, Cohen CR, Kungu D, Kuyoh MA, Onyango JA, Bwayo JJ, et al. Urine proves a poor specimen for culture of Trichomonas vaginalis in women. Sex Transm Infect 2001;77:78-9. Feldblum PJ, Bwayo JJ, Kuyoh M, Welsh M, Ryan KA, Chen-Mok M. The female condom and STDs: design of a community intervention trial. Ann Epidemiol 2000;10:339-46. Feldblum PJ, Chen-Mok M, Bwayo JJ, Omari M, Kuyoh M, Ryan KA. Intracluster correlation of STD prevalence in a community intervention trial in Kenya. Lancet 1999;354:1356-7. • • • • • Updated 11-2007 3 Operations Research Integrating Family Planning into Voluntary Counseling and Testing This study in Kenya examined the potential for introduction of family planning into HIV counseling clinics as a means of preventing births of infected children. It involved pre- and posttest operations research with provider, supervisor, and client interviews. Whether this strategy can both increase use of contraception and decrease unintended pregnancies remains unknown. • Reynolds HW, Liku J, Kimani J, and Beaston-Blaakman A. “Effect of Integrating Family Planning Services into Voluntary Counseling and Testing Centers in Kenya: Operations Research Results.” Family Health International, Research Triangle Park, NC, 2006. http://www.fhi.org/en/RH/Pubs/booksReports/FPVCTKenya.htm Best Practices in Preventing Mother-to-Child Transmission of HIV This cross-sectional research assesses practices in prevention of mother-to-child HIV transmission services and includes interviews with supervisors, providers and clients; an analysis of client flow; and a facility structured observation. Preventing Mother-to-Child Transmission of HIV among Adolescents This study was the first in Kenya to assess care provided to adolescents concerning prevention of vertical transmission of HIV during pregnancy. It was a cross-sectional study with youth in four large antenatal care programs and included interviews with supervisors, providers, clients and focus groups. • Reynolds et al., "An Assessment of Services for Adolescents in Prevention of Mother to Child Transmission Programs" YouthNet working paper No. 4. FHI, Research Triangle Park, NC, 2006. http://www.fhi.org/NR/rdonlyres/eedlvrphjdxqgk4ryukt4hf3pqalt3slitq6ffe73na7mxsr56r 4b3q6wubtdit5iczilz6pxvfl5f/YouthPMTCT.pdf Infant Nevirapine Dose Evaluation This cluster randomized trial of the take-home infant nevirapine dose includes interviews with supervisors, providers, and clients at two points in time. A manuscript of the main study results has been submitted for publication. Evaluation of a Global HIV Prevention Campaign This study examined the impact of HIV-prevention media messages on adolescents on three continents. Cross-sectional, population-based household survey data collected at three time points from three sites (Brazil, Nepal and Senegal) have been analyzed to describe adolescent media use and to determine exposure to and effectiveness of the campaign. Data on attitudes, beliefs, risk behavior, knowledge, use of health services and media could be used in secondary analyses. This is a very rich, but technical, data set. Analysis is in progress. Post-abortion Counseling of Adolescents in the Dominican Republic Interviews with providers and clients were conducted between February and July 2006 to evaluate the impact of the intervention efforts. Specific outcomes of interest include: counseling Updated 11-2007 4 on family planning, infections, warning signs and symptoms, and contraceptive uptake. We interviewed a total of 140 adolescent patients and 134 older patients. Analysis is in progress. Behavioral and Social Sciences Research Effectiveness of Youth Peer Education in Zambia Data on exposure to peer education and sexual risk behaviors were collected as part of the Zambia Sexual Behaviour Survey. Data on referrals and sexually transmitted infections were collected from clinics in six target areas. These two sets of data are being analyzed now to determine the effectiveness of peer education to reduce risk behavior and identify high-risk youth for counseling and testing. This also is a rich data set that could be used for secondary analyses. Early Sexual Debut in Jamaica This case-control study compared exposure to early sexual debut and sexual violence in groups of pregnant (cases) and non-pregnant (controls) in Jamaica. A number of potential mediating social and psychological variables were included in the questionnaire and would provide the opportunity for extensive secondary analyses. Updated 11-2007 5